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Türkün C, Gölgeli M, Atay FM. A mathematical interpretation for outbreaks of bacterial meningitis under the effect of time-dependent transmission parameters. NONLINEAR DYNAMICS 2023; 111:1-18. [PMID: 37361004 PMCID: PMC10235855 DOI: 10.1007/s11071-023-08577-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/08/2023] [Indexed: 06/28/2023]
Abstract
We consider a SIR-type compartmental model divided into two age classes to explain the seasonal exacerbations of bacterial meningitis, especially among children outside of the meningitis belt. We describe the seasonal forcing through time-dependent transmission parameters that may represent the outbreak of the meningitis cases after the annual pilgrimage period (Hajj) or uncontrolled inflows of irregular immigrants. We present and analyse a mathematical model with time-dependent transmission. We consider not only periodic functions in the analysis but also general non-periodic transmission processes. We show that the long-time average values of transmission functions can be used as a stability marker of the equilibrium. Furthermore, we interpret the basic reproduction number in case of time-dependent transmission functions. Numerical simulations support and help visualize the theoretical results.
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Affiliation(s)
- Can Türkün
- Department of Mathematics, TOBB University of Economics and Technology, Ankara, Turkey
- Present Address: Department of Industrial Engineering, Altınbaş University, Istanbul, Turkey
| | - Meltem Gölgeli
- Department of Mathematics, TOBB University of Economics and Technology, Ankara, Turkey
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Al-Tawfiq JA, Chopra H, Dhama K, Sah R, Schlagenhauf P, Memish ZA. The cholera challenge: How should the world respond? New Microbes New Infect 2022; 51:101077. [PMID: 36654941 PMCID: PMC9841269 DOI: 10.1016/j.nmni.2022.101077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, USA
- Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, USA
| | - Hitesh Chopra
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute (IVRI), Izatnagar, 243122, Bareilly, Uttar Pradesh, India
| | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
- Dr. Y Patl Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Patricia Schlagenhauf
- WHO Collaborating Centre for Travellers' Health, Institute for Epidemiology, Biostatistics and Prevention, University of Zürich Centre for Travel Medicine, MilMedBiol Competence Centre, University of Zürich, Switzerland
| | - Ziad A Memish
- Al-Faisal University, Riyadh, Saudi Arabia
- King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Badur S, Khalaf M, Öztürk S, Al-Raddadi R, Amir A, Farahat F, Shibl A. Meningococcal Disease and Immunization Activities in Hajj and Umrah Pilgrimage: a review. Infect Dis Ther 2022; 11:1343-1369. [PMID: 35585384 PMCID: PMC9334481 DOI: 10.1007/s40121-022-00620-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/04/2022] [Indexed: 11/24/2022] Open
Abstract
Invasive meningococcal disease (IMD) outbreaks associated with Hajj and Umrah pilgrimage events in the Kingdom of Saudi Arabia (KSA) are well recognized. Past outbreaks have been associated with substantial intercontinental spread of specific Neisseria meningitidis serogroups. The emergence of meningococcal serogroup W (MenW) was a global concern following the 2000/2001 Hajj outbreaks. Broader compulsory meningococcal serogroups A, C, W and Y (MenACWY) immunization strategies for pilgrims were introduced in response to these events and led to substantial declines in IMD cases associated with these mass gatherings. However, there remains potential for future outbreaks either within KSA during the Hajj or in local populations via pilgrim meningococcal transmission on their return. While the annual Hajj involves pilgrims from over 185 countries, two-thirds of these arrive from 13 countries, chiefly from across South-East Asia, the Middle East and North African (MENA) regions; for which we review the relevant epidemiology of IMD and meningococcal carriage. While disease surveillance is limited and data are often lacking, MenB is an important serogroup associated with IMD and carriage in a number of countries. Available literature suggests that most pilgrims receive polysaccharide MenACWY vaccines (which do not impact carriage and onward transmission) and incomplete compliance with visa/entry immunization regulations is reported. Existing preventative approaches for visiting pilgrims require continued oversight. More complete compliance and switching to the conjugated MenACWY vaccine can provide more robust and broader protection for pilgrims. Additional immunization options could also be considered.
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Affiliation(s)
- Selim Badur
- EM, Vaccines Scientific Affairs and Public Health, GSK, Büyükdere Caddesi No:173, 1, Levent Plaza B Blok, 34394 Istanbul, Turkey
| | - Mansour Khalaf
- Medical & Clinical Emerging Markets, GSK, Istanbul, Turkey
| | | | - Rajaa Al-Raddadi
- Department of Community Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ashraf Amir
- Department of Medicine, International Medical Center, Jeddah, Saudi Arabia
| | - Fayssal Farahat
- Infection Prevention and Control Program, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Atef Shibl
- College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
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Coudeville L, Amiche A, Rahman A, Arino J, Tang B, Jollivet O, Dogu A, Thommes E, Wu J. Disease transmission and mass gatherings: a case study on meningococcal infection during Hajj. BMC Infect Dis 2022; 22:275. [PMID: 35317742 PMCID: PMC8938638 DOI: 10.1186/s12879-022-07234-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/02/2022] [Indexed: 11/28/2022] Open
Abstract
Background Mass gatherings can not only trigger major outbreaks on-site but also facilitate global spread of infectious pathogens. Hajj is one of the largest mass gathering events worldwide where over two million pilgrims from all over the world gather annually creating intense congestion. Methods We developed a meta-population model to represent the transmission dynamics of Neisseria meningitidis and the impact of Hajj pilgrimage on the risk of invasive meningococcal disease (IMD) for pilgrims population, local population at the Hajj site and country of origin of Hajj pilgrims. This model was calibrated using data on IMD over 17 years (1995–2011) and further used to simulate potential changes in vaccine policy and endemic conditions. Results The effect of increased density of contacts during Hajj was estimated to generate a 78-fold increase in disease transmission that impacts not only pilgrims but also the local population. Quadrivalent ACWY vaccination was found to be very effective in reducing the risk of outbreak during Hajj. Hajj has more limited impact on IMD transmission and exportation in the pilgrim countries of origin, although not negligible given the size of the population considered. Conclusion The analysis performed highlighted the amplifying effect of mass gathering on N. meningitidis transmission and confirm vaccination as a very effective preventive measure to mitigate outbreak risks. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07234-4.
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Khan ML, Malik A, Ruhi U, Al-Busaidi A. Conflicting attitudes: Analyzing social media data to understand the early discourse on COVID-19 passports. TECHNOLOGY IN SOCIETY 2022; 68:101830. [PMID: 34898757 PMCID: PMC8653408 DOI: 10.1016/j.techsoc.2021.101830] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 05/05/2023]
Abstract
In several countries, vaccine passports are being encouraged to hasten the return to some form of normalcy amidst the COVID-19 pandemic. Vaccine passport is a digital or paper document that may serve as proof of the COVID-19 vaccine, thereby allowing entry to public venues, sporting events, air travel, and unrestricted access to other facilities. This study explores how the COVID-19 passport is being discussed and perceived on Twitter and the prominent entities involved in the early discourse on the issue. Twitter messages were theoretically analyzed for Health Belief Model (HBM) and Theory of Planned Behavior (TPB) variables, as well as message source, engagement, and attitudes towards vaccination certificates. Using quantitative content analysis, tweets were coded on nine dimensions: account type, tweeter profile, tweet content, tweet modality, attitude, self-efficacy, perceived barriers, benefits, and action cues. Most of the tweets originated from personal accounts, followed by media organizations, media-related personalities, politicians, and the travel industry. A significant number of tweets were from male Twitter users. Our analysis revealed that most tweeters had a favorable attitude towards the COVID-19 passports. Unfavorable attitudes toward the COVID-19 passport were based on reasons such as a lack of common standard or consensus, and personal freedoms & human rights. Tweets highlighting the benefits of COVID-19 passports cited travel as the primary reason. Based on a combination of technical, legal, and ethical practices, our study offers a set of vital recommendations for governments, health organizations, and businesses that may help stimulate the acceptance of vaccine passports.
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Affiliation(s)
- M Laeeq Khan
- Associate Professor and Director, Social Media Anaytics Research Team (SMART) Lab, Scripps College of Communication, Ohio University, USA
| | - A Malik
- Assistant Professor, Department of Information Systems, Sultan Qaboos University, Oman
| | - U Ruhi
- Associate Professor and Director, Centre for Business Analytics & Performance, Telfer School of Management, University of Ottawa, Canada
| | - A Al-Busaidi
- Assistant Professor of Organizational Communication, and Director of Innovation and Technology Transfer Center, Sultan Qaboos University, Oman
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Said KB, Alsolami A, Khalifa AM, Khalil NA, Moursi S, Osman A, Fahad D, Rakha E, Rashidi M, Moussa S, Bashir AI, Alfouzan F, Hammam S, Taha TE, Al-hazimi A, Al Jadani A. A Multi-Point Surveillance for Antimicrobial Resistance Profiles among Clinical Isolates of Gram-Negative Bacteria Recovered from Major Ha'il Hospitals, Saudi Arabia. Microorganisms 2021; 9:microorganisms9102024. [PMID: 34683344 PMCID: PMC8537776 DOI: 10.3390/microorganisms9102024] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/18/2021] [Accepted: 09/20/2021] [Indexed: 12/18/2022] Open
Abstract
The devastating nosocomial resistance is an on-going global concern. Surveillance of resistance is crucial for efficient patient care. This study was aimed to conduct a surveillance in four major Ha'il Hospitals from September to December 2020. Using a multipoint program, records of 621 non-duplicate Gram-negative cultures were tested across 21 drugs belonging to different categories. Major species were Klebsiella pneumoniae (n = 187, 30%), E. coli (n = 151, 24.5%), Pseudomonas aeruginosa, (n = 84, 13.6%), Acinetobacter baumannii (n = 82, 13.3%), and Proteus mirabilis (n = 46, 7%). Based on recent resistance classifications, A. baumanni, P. aeruginosa, and enteric bacteria were defined as pan-resistant, extremely resistant, and multi-drug resistant, respectively. A. baumannii (35%) and K. pneumoniae (23%) dominated among coinfections in SARS-CoV2 patients. The "other Gram-negative bacteria" (n = 77, 12.5%) from diverse sources showed unique species-specific resistance patterns, while sharing a common Gram-negative resistance profile. Among these, Providencia stuartii was reported for the first time in Ha'il. In addition, specimen source, age, and gender differences played significant roles in susceptibility. Overall infection rates were 30% in ICU, 17.5% in medical wards, and 13.5% in COVID-19 zones, mostly in male (59%) senior (54%) patients. In ICU, infections were caused by P. mirabilis (52%), A. baumannii (49%), P. aeruginosa (41%), K. pneumoniae (24%), and E. coli (21%), and most of the respiratory infections were caused by carbapenem-resistant A. baumannii and K. pneumoniae and UTI by K. pneumoniae and E. coli. While impressive IC, hospital performances, and alternative treatment options still exist, the spread of resistant Gram-negative bacteria is concerning especially in geriatric patients. The high selective SARS-CoV2 coinfection by A. baumannii and K. pneumoniae, unlike the low global rates, warrants further vertical studies. Attributes of resistances are multifactorial in Saudi Arabia because of its global partnership as the largest economic and pilgrimage hub with close social and cultural ties in the region, especially during conflicts and political unrests. However, introduction of advanced inter-laboratory networks for genome-based surveillances is expected to reduce nosocomial resistances.
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Affiliation(s)
- Kamaleldin B. Said
- Department of Pathology, College of Medicine, University of Ha’il, Ha’il 55476, Saudi Arabia; (A.M.K.); (N.A.K.); (S.M.)
- Genomics, Bioinformatics and Systems Biology, Carleton University, 1125 Colonel-By Drive, Ottawa, ON K1S 5B6, Canada
- ASC Molecular Bacteriology, McGill University, 21111 Lakeshore Rd, Montreal, QC H9X 3L9, Canada
- Correspondence: ; Tel.: +966-500771459
| | - Ahmed Alsolami
- Department of Internal Medicine, College of Medicine, University of Ha’il, Ha’il 55476, Saudi Arabia; (A.A.); (A.A.J.)
| | - Amany M. Khalifa
- Department of Pathology, College of Medicine, University of Ha’il, Ha’il 55476, Saudi Arabia; (A.M.K.); (N.A.K.); (S.M.)
| | - Nuha A. Khalil
- Department of Pathology, College of Medicine, University of Ha’il, Ha’il 55476, Saudi Arabia; (A.M.K.); (N.A.K.); (S.M.)
| | - Soha Moursi
- Department of Pathology, College of Medicine, University of Ha’il, Ha’il 55476, Saudi Arabia; (A.M.K.); (N.A.K.); (S.M.)
| | - Abuzar Osman
- Department of Pharmacology, College of Medicine, University of Ha’il, Ha’il 55476, Saudi Arabia;
| | - Dakheel Fahad
- Departments of Microbiology, Education, Research and Training, King Khalid Hospital, Ha’il 55476, Saudi Arabia; (D.F.); (E.R.)
| | - Ehab Rakha
- Departments of Microbiology, Education, Research and Training, King Khalid Hospital, Ha’il 55476, Saudi Arabia; (D.F.); (E.R.)
- Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Musleh Rashidi
- Ministry of Health, Hail Region, Ha’il 55476, Saudi Arabia;
| | - Safia Moussa
- Department of Microbiology, King Salman Specialist Hospital, Ha’il 55476, Saudi Arabia; (S.M.); (F.A.)
| | - Abdelhafiz I. Bashir
- Department of Physiology, College of Medicine, University of Hail, Ha’il 55476, Saudi Arabia; (A.I.B.); (A.A.-h.)
| | - Fayez Alfouzan
- Department of Microbiology, King Salman Specialist Hospital, Ha’il 55476, Saudi Arabia; (S.M.); (F.A.)
| | - Sahar Hammam
- Department of Microbiology, Maternity and Children Hospital, Ha’il 55476, Saudi Arabia;
| | - Taha E. Taha
- Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Awdah Al-hazimi
- Department of Physiology, College of Medicine, University of Hail, Ha’il 55476, Saudi Arabia; (A.I.B.); (A.A.-h.)
| | - Ahmed Al Jadani
- Department of Internal Medicine, College of Medicine, University of Ha’il, Ha’il 55476, Saudi Arabia; (A.A.); (A.A.J.)
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Badur S, Al Dabbagh MA, Shibl AM, Farahat FM, Öztürk S, Saha D, Khalaf M. The Epidemiology of Invasive Meningococcal Disease in the Kingdom of Saudi Arabia: A Narrative Review with Updated Analysis. Infect Dis Ther 2021; 10:2035-2049. [PMID: 34390485 PMCID: PMC8363858 DOI: 10.1007/s40121-021-00467-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 05/24/2021] [Indexed: 11/26/2022] Open
Abstract
Reducing invasive meningococcal disease (IMD) through MenACWY immunization is a critical healthcare strategy in the Kingdom of Saudi Arabia (KSA). Robust IMD surveillance is essential to help assess the need for additional immunization initiatives in target populations. This is particularly important in KSA, where mass gatherings accompanying Hajj/Umrah pilgrimages have been associated with IMD outbreaks within the local KSA population, and subsequent intercontinental spread via returning pilgrims. This narrative review of the published literature describes the changing epidemiology of IMD in KSA to provide a perspective on the impact of current immunization strategies and potential gaps. As recent published surveillance data are lacking, we also evaluated publicly reported data from the KSA Ministry of Health (MoH) for 2012–2019 to inform more recent IMD trends. Between 1995 and 2011, national surveillance data indicate that 1103 IMD cases were reported in KSA: 60% in 2000–2001, involving two (mainly MenW) outbreaks involving KSA citizens/residents and pilgrims focused in Mecca and Medina. Across 2002–2011, 184 cases of IMD were reported, with a higher proportion occurring in KSA citizens/residents, and with less focus within pilgrimage centers than apparent in previous years. Our analysis of MoH data found that, between 2012 and 2019, 44 IMD cases were reported, all in KSA citizens/residents, and chiefly in children or infants. No pilgrimage-associated outbreaks have occurred since 2001. Serogroup data were available for 62.5% of all cases for 2002–2011; MenW (40.0%), MenA (35.7%), and MenB (16.5%). Serogroup data for 2012–2019 remain incompletely reported, and the existing surveillance system could be improved, as some element of underestimation/underreporting of IMD may exist. While existing MenACWY immunization strategies for KSA citizens/residents and visiting pilgrims have been successful in reducing IMD due to specific serogroups, disease due to MenB remains a potential risk, and additional immunization strategies should be considered.
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Affiliation(s)
- Selim Badur
- EM, Vaccines Scientific Affairs and Public Health, GSK, Büyükdere Caddesi No:173, 1, Levent Plaza B Blok, 34394, Istanbul, Turkey.
| | - Mona A Al Dabbagh
- Division of Infectious Diseases, Department of Pediatrics, King Abdulaziz Medical City, King Abdullah International Medical Research Centre, King Saud Bin Abdulaziz University for Health Sciences, Jidda, Saudi Arabia
| | - Atef M Shibl
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Fayssal M Farahat
- Infection Prevention and Control Program, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jidda, Saudi Arabia
| | - Serdar Öztürk
- Medical & Clinical Emerging Markets, GSK, Istanbul, Turkey
| | - Debasish Saha
- Clinical Research and Development, GSK, Wavre, Belgium
| | - Mansour Khalaf
- EM Central Vaccines Medical/Clinical, GSK, Jidda, Saudi Arabia
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Dubey AP, Hazarika RD, Abitbol V, Kolhapure S, Agrawal S. Mass gatherings: a review of the scope for meningococcal vaccination in the Indian context. Hum Vaccin Immunother 2021; 17:2216-2224. [PMID: 33605845 PMCID: PMC8189129 DOI: 10.1080/21645515.2020.1871572] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/30/2020] [Indexed: 11/17/2022] Open
Abstract
The risk of meningococcal transmission is increased with crowding and prolonged close proximity between people. There have been numerous invasive meningococcal disease (IMD) outbreaks associated with mass gatherings and other overcrowded situations, including cramped accommodation, such as student and military housing, and refugee camps. In these conditions, IMD outbreaks predominantly affect adolescents and young adults. In this narrative review, we examine the situation in India, where the burden of IMD-related complications is significant but the reported background incidence of IMD is low. However, active surveillance for meningococcal disease is suboptimal and laboratory confirmation of meningococcal strain is near absent, especially in non-outbreak periods. IMD risk factors are prevalent, including frequent mass gatherings and overcrowding combined with a demographically young population. Since overcrowded situations are generally unavoidable, the way forward relies on preventive measures. More widespread meningococcal vaccination and strengthened disease surveillance are likely to be key to this approach.
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Affiliation(s)
- Anand P Dubey
- Pediatrics, ESI-PGIMSR & Model Hospital, New Delhi, India
| | - Rashna Dass Hazarika
- Pediatrics, Nemcare Superspeciality Hospital, Bhangagarh, Guwahati, and RIGPA Children’s Clinic, Guwahati, India
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Al-Tawfiq JA, Memish ZA. The Emergence, Persistence, and Dissemination of Antimicrobial-Resistant Bacteria in Environmental Hajj Settings and Implications for Public Health. Trop Med Infect Dis 2021; 6:33. [PMID: 33802167 PMCID: PMC8005974 DOI: 10.3390/tropicalmed6010033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 11/21/2022] Open
Abstract
The emergence of antimicrobial resistance is causing the loss of what was once considered the miracle cure. The transmission of antimicrobial resistance during mass gathering is a potential threat in addition to other infectious diseases. Here, we review the English language literature on the rate and the acquisition of antimicrobial resistance during the Hajj. There is a variable incidence of methicillin-resistant Staphylococcus aureus, Escherichia coli, and Enterobacteriaceae. There had been no report of multi-drug-resistant Mycobacterium tuberculosis. Continued surveillance of antimicrobial resistance coupled with public health measures are needed to decrease the rate of emergence of resistance.
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Affiliation(s)
- Jaffar A. Al-Tawfiq
- Specialty Internal Medicine and Quality Division, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia;
- Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21093, USA
| | - Ziad A. Memish
- Director Research and Innovation Center, King Saud Medical City, Ministry of Health, Riyadh 12746, Saudi Arabia
- Al-Faisal University, Riyadh 11533, Saudi Arabia
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
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Fteiha B, Rub TA, Schwartz E, Lachish T. Morbidity among Arab-Israeli and Palestinian Hajj Pilgrims: A Prospective Study. Am J Trop Med Hyg 2021; 104:1596-1601. [PMID: 33534767 DOI: 10.4269/ajtmh.20-1460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/13/2020] [Indexed: 11/07/2022] Open
Abstract
Thousands of Palestinian and Arab-Israeli pilgrims travel to Mecca each year to complete their pilgrimage. To the best of our knowledge, no previous studies have characterized the infectious and noninfectious morbidity among Arab-Israeli or Palestinian Hajj pilgrims. Thus, we designed and conducted an observational questionnaire-based study to prospectively investigate the occurrence of health problems among these Hajjis who traveled to complete their Pilgrimage during 2019 Hajj season. For the purpose of the study, questionnaires were distributed to Hajj pilgrims at three different time occasions-before travel, inquiring on demographics and medical comorbidities; and 1 and 4 weeks after returning recording any health problems encountered during or after travel. Initial recruitment included 111 Hajjis. The mean age of responders was 49.5 (±9.1) years, with an M:F ratio of 1.3:1. The mean travel duration was 18.7 (13-36) days. Altogether, 66.3% of the pilgrims reported at least one health problem during and after the trip, of which 38.6% sought medical attention. Five (4.8%) hajjis were hospitalized, including life-threatening conditions. Cough was the most common complaint (53.8%), and 11.5% also reported fever. Pretravel counseling was associated with reduced outpatient and emergency room visits. We therefore concluded that a high rate of morbidity was reported among this cohort of Hajj pilgrims with a morbidity spectrum similar to pilgrims from other countries. Pretravel consultation with the purpose of educating the pilgrims on the health risks of Hajj may help reduce the morbidity for future Hajj seasons.
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Affiliation(s)
- Bashar Fteiha
- 1Digestive Diseases Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Tawfiq Abul Rub
- 2The Internal Medicine Ward, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Eli Schwartz
- 3The Center for Travel and Tropical Medicine, Sheba Medical Center, Tel Hashomer and the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamar Lachish
- 4The Infectious Diseases Unit, Shaare-Zedek Medical Center, and the Hebrew University School of Medicine, Jerusalem, Israel
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Tobaiqy M, Alhasan AH, Shams MM, Amer SA, MacLure K, Alcattan MF, Almudarra SS. Assessment of Preventative Measures Practice among Umrah Pilgrims in Saudi Arabia, 1440H-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E257. [PMID: 33396376 PMCID: PMC7796344 DOI: 10.3390/ijerph18010257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 11/23/2022]
Abstract
:Background: Annually, approximately 10 million pilgrims travel to the Kingdom of Saudi Arabia (KSA) for Umrah from more than 180 countries. This event presents major challenges for the Kingdom's public health sector, which strives to decrease the burden of infectious diseases and to adequately control their spread both in KSA and pilgrims home nations. The aims of the study were to assess preventative measures practice, including vaccination history and health education, among Umrah pilgrims in Saudi Arabia. Methods: A cross sectional survey was administered to pilgrims from February to April 2019 at the departure lounge at King Abdul Aziz International airport, Jeddah city. The questionnaire comprised questions on sociodemographic information (age, gender, marital status, level of education, history of vaccinations and chronic illnesses), whether the pilgrim had received any health education and orientation prior to coming to Saudi Arabia or on their arrival, and their experiences with preventative practices. Results: Pilgrims (n = 1012) of 41 nationalities completed the survey. Chronic diseases were reported among pilgrims (n = 387, 38.2%) with cardiovascular diseases being the most reported morbidity (n = 164, 42.3%). The majority of pilgrims had been immunized prior to travel to Saudi Arabia (n = 770, 76%). The most commonly reported immunizations were influenza (n = 514, 51%), meningitis (n = 418, 41%), and Hepatitis B virus vaccinations (n = 310, 31%). However, 242 (24%) had not received any vaccinations prior to travel, including meningitis vaccine and poliomyelitis vaccine, which are mandatory by Saudi Arabian health authorities for pilgrims coming from polio active countries. Nearly a third of pilgrims (n = 305; 30.1%) never wore a face mask in crowded areas during Umrah in 2019. In contrast, similar numbers said they always wore a face mask (n = 351, 34.6%) in crowded areas, while 63.2% reported lack of availability of face masks during Umrah. The majority of participants had received some form of health education on preventative measures, including hygiene aspects (n = 799, 78.9%), mostly in their home countries (n = 450, 44.4%). A positive association was found between receiving health education and practicing of preventative measures, such as wearing face masks in crowded areas (p = 0.04), and other health practice scores (p = 0.02). Conclusion: Although the experiences of the preventative measures among pilgrims in terms of health education, vaccinations, and hygienic practices were at times positive, this study identified several issues. These included the following preventative measures: immunizations, particularly meningitis and poliomyelitis vaccine, and using face masks in crowded areas. The recent COVID-19 pandemic highlights the need for further studies that focus on development of accessible health education in a form that engages pilgrims to promote comprehensive preventative measures during Umrah and Hajj and other religious pilgrimages.
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Affiliation(s)
- Mansour Tobaiqy
- Department of Pharmacology, College of Medicine, University of Jeddah, Jeddah 21512, Saudi Arabia
| | - Ahmed H. Alhasan
- Jeddah Eye Hospital, Ministry of Health, Jeddah 23331, Saudi Arabia;
| | - Manal M. Shams
- Health and Lifestyle Department, Ministry of Health (MOH), Riyadh 11176, Saudi Arabia;
| | - Samar A. Amer
- Public Health and Community Medicine, Zagazig University, Zagazig 44519, Egypt;
- Public Health, Ministry of Health (MOH), Riyadh 11176, Saudi Arabia
| | - Katie MacLure
- Independent Research Consultant, Aberdeen AB32 6RU, UK;
| | | | - Sami S. Almudarra
- Epidemiology, Surveillance and Preparedness, Saudi CDC, General Supervisor of Saudi Field Epidemiology Training Program, Ministry of Health (MOH), Riyadh 11176, Saudi Arabia;
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